Columbia University

Problem:

Nationally, there is insufficient pediatric dental leadership addressing the poor oral health of children and youth made vulnerable by special needs or social condition. This is in part due to lack of professional training that promotes alternative careers in academe, public service, and venues targeting at-risk children and their families. GOALS & OBJECTIVES: Goal 1: Establish and manage an innovative Pediatric Dentistry Residency and Fellowship training program that promotes alternative careers in pediatric dentistry Objective 1: Within 1 year, revamp, merge, and expand existing program for 10 Residents, 1 Head Start Fellow, and 1 Hospitalist Fellow annually. Objective 2: Over 5 years, replicate the existing Columbia Head Start liaison at 2-5 additional Head Start/ Early Head Start sites in Northern Manhattan. Goal 2: Continue and enrich the current substantive bilateral training partnership with the University of Puerto Rico to enhance the quality and reach of both training programs. Objective 1: Within 1 year, develop and implement with UPR the technical capacity for distance education involving 20 trainees (8 in San Juan, 12 in NY City) Objective 2: Within 1 year, implement a 2-week annual bilateral exchange for 4 trainees. Objective 3: Over 5 years, provide didactic and experiential learning opportunities to trainees in both institutions on cultural competency and public health for 100 trainees. Goal 3: Promote and facilitate Columbia, UPR, and Region II trainees entrance into alternative careers in pediatric dentistry. Objective 1: Over 5 years triple the number of Columbia program completers who elect full-time careers addressing the needs of MCH populations (from a base of 3 to a target of 9). Objective 2: During each of 5 years, provide regional continuing education that highlights and promotes alternative careers for 162 Region II pediatric dentistry trainees in NY, NJ, PR. ACTIVITIES: Goal 1 related activities: Revamping the current Pediatric Dentistry Residency (PedDent) while retaining its clinical strengths, continuing the current Head Start Fellowship (HSFPD), and adding a new Pediatric Dentistry Hospitalist Fellowship that focuses on children and youth with special healthcare needs (CYSHCN) requires new curricula development, staffing modifications, scheduling changes, clinical experiences adjustments, faculty skill set training, administrative structure change, and trainee recruitment modifications to attract appropriate Residents and Fellows. We will thereby enhance training components on leadership, public health, interdisciplinary care, cultural competency, family centered care, research, emerging issues, linkages to Title V, and lifelong learning. These changes will parallel changes we have previously implemented in developing community-based training for AEGD Residents under a HRSA HIV/AIDS service grant and the current Head Start Fellowship. Continuing the current Head Start liaison and expanding it to more sites also requires a range of activities involving networking, negotiation, program planning and implementation. Goal 2 related activities: Extending the UPR relationship to include weekly video-seminars and student exchanges requires activities including making technologic arrangements, logistic arrangements, and sharing in the development and delivery of new didactic and experiential curricula based on shared teaching objectives. Goal 3 related activities: Activities planned for facilitating career awareness, interest, and planning for transition from training into employment in non-traditional positions that support MCH populations involve intensive establishing mentoring, advising, and education for our trainees. To extend the reach of this effort, we will experiment with incorporating these features through distance technologies with UPR residents. Lastly, we will provide annual education programs for Region II pediatric dentistry trainees who comprise 1/4th of all trainees nationally. To fully realize this program’s potential to stimulate leadership, develop educational resources, and provide multidisciplinary consultation, technical assistance, and support we will also engage in activities involving evaluation, dissemination, and networking with other trainees, MCH communities of interest, the CYSCHN communities, and Head Start programs. HP2010 OBJECTIVES: Among the 23 HP2010 Objectives specifically addressed by this proposal, those most directly promoted are (1) improvements in children’s oral health [21-1, 2]; (2) preventive visits by low-income youth [21-12]; (3) training for care of CYSHCN [1-14]; (4) access to quality healthcare through counseling [1-3]; and (5) interdisciplinary training [1-7].

Coordination:

This training serves children and families who are also served by many local, state and national MCH programs. Head Start coordination is planned with neighborhood, City, and State and Region II Head Start programs and officials (as is currently done through our Head Start Fellowship). Coordination is similarly planned for CYSHCN as we develop the Hospitalist Fellowship. Planned are outreach and coordination with other MCHB-sponsored trainees nationally and in New York and dissemination through MCHB Resource Centers.

Evaluation:

Success meeting the Project’s objectives will be assessed through a process and outcomes approach using specific measures for each objective. Qualitative and quantitative methods to be used with trainees, faculty, families, and product end-users include interviews, surveys, real-time data tracking, focus groups, and pre-post intervention knowledge testing.